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Violence: Even Our Hospitals Are Not Immune

The tragic murder-suicide case and shooting of a doctor that recently occurred at Johns Hopkins hospital illustrates the prevalence of violence today. And as an ER doctor, I have seen violence first hand, and all too often. I always tell people the emergency department is a microcosm of society; we see and take care of all of our societal ills, such as domestic violence, homelessness, gun and gang violence, mental illness and drug addiction. It is no surprise that sometimes this violence spills over into the ER.

The tragic murder-suicide case and shooting of a doctor that recently occurred at Johns Hopkins hospital illustrates the prevalence of violence today. And as an ER doctor, I have seen violence first hand, and all too often. I always tell people the emergency department is a microcosm of society; we see and take care of all of our societal ills, such as domestic violence, homelessness, gun and gang violence, mental illness and drug addiction. It is no surprise that sometimes this violence spills over into the ER.

A study published in Annals of Emergency Medicine in 2005 found that both verbal and physical assaults take place regularly in ERs; 75% of emergency physicians reported verbal threats, 28% reported physical assaults, 12% were confronted outside the emergency department and 3.5% have been stalked. And according to the Bureau of Labor and Statistics, healthcare is considered one of the more dangerous professions. Workers in this field are twice as likely to be injured from violence in their workplace.

And while the danger is not as serious as it is for police officers, it does go with the territory and it does become routine at the job. And this means much of the violence is underreported! I personally don’t know a single ER doctor, nurse or tech that hasn’t experienced a confrontation to some degree.

The other issue that makes emergency departments particularly vulnerable is that emotions run high in ERs. People are sick and injured, many are in life and death situations, and often, in a lot of pain. Families and patients alike are frightened and sometimes frustrated by waiting for diagnosis and prognosis. Add to that the simple fact that no one wants to be in an emergency department.

But with all the tragedy and violence around them every day, often ER staffs makes light of the violence and threats in an attempt to cope and reduce stress levels. However, the recent incident in Baltimore makes us realize how very serious it is. The key is to balance it all; to not become complacent, to remain vigilant in watching out for it, to follow hospital protocols when an incident occurs, but not to allow it to take over your work life.

Even though I can vividly remember an incident when one patient put me in a chokehold, it still pales in comparison to the countless memories of patients and family members who thanked me for taking good care of their loved ones. And it’s the thanks, not the threats, that keep you coming back.

Blog written by Leigh Vinocur, MD FACEP
Dr. Leigh Vinocur is a board certified emergency physician and national spokesperson for the American College of Emergency...